Objective A novel index based on fi-equency-domain analysis of heart rate variability （HRV） was tested on patients with reduced left ventricular systolic function. This index, namely VHFI, was defined as the very hi...Objective A novel index based on fi-equency-domain analysis of heart rate variability （HRV） was tested on patients with reduced left ventricular systolic function. This index, namely VHFI, was defined as the very high frequency （VHF） component of the power spectrum normalized to represent its relative value in proportion to the total power minus the very low frequency component. Methods Patients （n = 130） were divided into a study group, consisting 66 patients with decreased left ventricular systolic function, and a control group, consisting 64 patients with normal heart structure and function and without severe coronary artery stenosis （〈 50%）. Results VHFI in the study group was significantly higher than that in the control group （19.17 ± 13.35 vs 11.37 ± 10.77, P 〈 0.001）. Cardiac events occurred in 18 patients during follow-up （33.34 i 3.26 months）. Defining the positive test as VHFI =15 and negative test as VHFI 〈15, achieved a sensitivity of 57.58% and a specificity of78.13% for predicting decreased left ventricular systolic function, and achieved a sensitivity of 66.67% and a specificity of 64.29% for predicting cardiac events. Univariate Cox regression analysis showed that positive VHFI test was an independent variable in predictive cardiac events. Conclusions The results suggest that VHFI is a useful tool for quick evaluation of left ventricular systolic function and prediction of prognosis展开更多
Assessing the dynamics of heart rate fluctuations can provide valuable information about heart status. In this study, regularity of heart rate variability （HRV） of heart failure patients and healthy persons using th...Assessing the dynamics of heart rate fluctuations can provide valuable information about heart status. In this study, regularity of heart rate variability （HRV） of heart failure patients and healthy persons using the concept of singular value decomposition entropy （SvdEn） is analyzed. SvdEn is calculated from the time series using normalized singular values. The advantage of this method is its simplicity and fast computation. It enables analysis of very short and non-stationary data sets. The results show that SvdEn of patients with congestive heart failure （CHF） shows a low value （SvdEn： 0.056±0.006, p 〈 0.01） which can be completely separated from healthy subjects. In addition, differences of SvdEn values between day and night are found for the healthy groups. SvdEn decreases with age. The lower the SvdEn values, the higher the risk of heart disease. Moreover, SvdEn is associated with the energy of heart rhythm. The results show that using SvdEn for discriminating HRV in different physiological states for clinical applications is feasible and simple.展开更多
Aim: Congestive heart failure (CHF) is a severe cardiovascular disorder seen in the Emergency Department (ED). B-type Natriuretic Peptide (BNP) is usually ordered to evaluate the CHF severity. However, it is difficult...Aim: Congestive heart failure (CHF) is a severe cardiovascular disorder seen in the Emergency Department (ED). B-type Natriuretic Peptide (BNP) is usually ordered to evaluate the CHF severity. However, it is difficult to interpret serum BNP level when different clinical entities existed. The aim of this study is to illustrate the correlation between serum BNP level and relevant clinical variables and further determine the role of serum BNP in different CHF patients. Methods: Univariate comparisons between 26 clinical variables and serum BNP level were analyzed. In order to avoid confounding factors, potential independent clinical variables were analyzed together using multivariate regression. Results: 529 CHF patients were reviewed and divided into different groups by 26 clinical variables. Serum BNP levels were found statistically significant different by univariate compareson between groups divided by 8 clinical variables that included obesity, diastolic/systolic heart failure (HF), serum blood urea nitrogen (BUN) level, serum creatinine (Cr) level, serum sodium (Na) level, patients taking loop diuretics, history of cerebrovascular accident (CVA), and history of dementia. Among all 8 clinical variables, obesity, serum BUN, Cr level, and diastolic/systolic HF had weak-to-moderate correlation effects with serum BNP level by correlation coefficient analysis. However, only obesity and dia- stolic/systolic HF were two moderately stronger clini- cal variables that can affect the serum BNP levels by multivariate regression. Analyzing CHF patients separately by obesity and diastolic/systolic HF subsets showed longer hospitalization in diastolic HF patients with relatively higher serum Cr level. In addition, poor correlation was found between serum BNP level and length of hospitalization (LOH) as well. Conclusion: High variability of serum BNP levels exists in CHF patients with weak-to-moderate correlation effects particularly on obesity and diastolic/systolic HF.It is recommended that physicians should be cautious on interpreting BNP in different CHF populations.展开更多
Nonlinear analysis of heart rate variability （HRV） has become important as heart behaves as a complex system. In this work, the approximate entropy （ApEn） has been used as a nonlinear measure. A new concept of est...Nonlinear analysis of heart rate variability （HRV） has become important as heart behaves as a complex system. In this work, the approximate entropy （ApEn） has been used as a nonlinear measure. A new concept of estimating the ApEn in different segments of long length of the recorded data called modified multiple scale （segment） entropy （MMPE） is introduced. The idea of estimating the approximate entropy in different segments is useful to detect the nonlinear dynamics of the heart present in the entire length of data. The present work has been carried out for three cases namely the normal healthy heart （NHH） data, congestive heart failure （CHF） data and Atrial fibrillation （AF） data and the data are analyzed using MMPE techniques. It is observed that the mean value of ApEn for NHH data is much higher than the mean values for CHF data and AF data. The ApEn profiles of CHF, AF and NHH data for different segments obtained using MPE profiles measures the heart dynamism for the three different cases. Also the power spectral density is obtained using fast fourier transform （FFT） analysis and the ratio of LF/HF （low frequency/high frequency） power are computed on multiple scales/segments namely MPLH （multiple scale low frequency to high frequency） for the NHH data, CHF data and AF data and analyzed using MPLH techniques. The results are presented and discussed in the paper.展开更多
Background Chronic heart failure(CHF)is the end-stage manifestation and main cause of death of cardiovascular system diseases.Ventricular arrhythmia is a common complication,which can increase myocardial oxygen consum...Background Chronic heart failure(CHF)is the end-stage manifestation and main cause of death of cardiovascular system diseases.Ventricular arrhythmia is a common complication,which can increase myocardial oxygen consumption,aggravate the disease,and even cause sudden death due to malignant arrhythmia.As a quantitative method to evaluate cardiac autonomic nervous function,heart rate variability is non-invasive and reproducible,and can quantify the risk associated with various cardiac and non-cardiac diseases.The purpose of this study was to analyze the correlation between heart rate variability and the incidence of cardiovascular adverse events in patients with heart failure.Methods 80 patients with heart failure who were treated in our hospital from May 2020 to May 2022 were selected as the study objects.After 3 months of follow-up,patients were divided into occurrence group(n=44)and nonoccurrence group(n=36)according to the occurrence of adverse cardiovascular events(angina pectoris,myocardial infarction,arrhythmia).The index of heart rate variability and the indicators of cardiac function in patients with heart failure was analyzed by one-way analysis of variance(ANOVA).The Key indicators of heart rate variability include standard deviation of normal RR interval(SDNN),mean standard deviation of consecutive 5-minute heartbeat interval(SDANN),square root of mean square of difference between adjacent heartbeat intervals(RMSSD),and percentage of RR intervals differing more than 50 ms from the preceding one(PNN50).The indicators of cardiac function include the New York Heart Association(NYHA)functional classification,left ventricular ejection fraction(LVEF),brain natriuretic peptide(BNP)and cardiac troponin I(c Tn I).Multivariate logistic regression was used to analyze the incidence of cardiovascular adverse events in patients with heart failure.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of heart rate variability in patient outcomes.The correlation between heart rate variability and the incidence of cardiovascular adverse events was analyzed by Kendall's tau-b analysis.Results There were significant differences in SDNN,SDANN,RMSSD,PNN50,cardiac function grade,LVEF and BNP level between the two groups(P<0.05).Through logistic regression analysis,SDNN,SDANN,RMSSD and PNN50 were independent predictors for the incidence of cardiovascular adverse events(P<0.05).The areas under curve for SDNN,SDANN,RMSSD,and PNN50 predicting of the incidence of cardiovascular adverse events were 0.732,0.732,0.758,and 0.819 respectively,and the sensitivity was 77.27%,81.81%,75.00%and 65.91%,respectively.The specificity was 61.11%,61.11%,80.56%,83.33%(P<0.05),respectively.Through Kendall's tau-b analysis,the index of heart rate variability was negatively correlated with the incidence of adverse cardiovascular events in patients with prognosis(P<0.05).Conclusions Heart rate variability has predictive value for the incidence of adverse cardiovascular events in patients with heart failure.The lower the heart rate variability,the higher incidence of cardiovascular adverse events.[S Chin J Cardiol 2024;25(3):135-141]展开更多
Background: Heart Failure (HF) is a major public health problem worldwide. Neurohormonal changes associated with HF are current therapeutic targets. The parasympathetic system in HF has not been well studied especiall...Background: Heart Failure (HF) is a major public health problem worldwide. Neurohormonal changes associated with HF are current therapeutic targets. The parasympathetic system in HF has not been well studied especially in black Africans. Aim: This study aimed to report on the prevalence and determinants of parasympathetic dysfunction in patients with heart failure in sub-Saharan Africa. Methods: We conducted a cross-sectional study between December 2017 and April 2018 in the outpatient and inpatient departments in two teaching hospitals in Yaounde-Cameroon. Cases were patients with HF matched with controls without HF according to age, sex, and risk factors (hypertension, diabetes, and obesity). We assessed the parasympathetic function via the Deep Breathing Test using an electrocardiograph. Results: We recruited 35 patients in each group. The mean age was 57 ± 11.68 years. Vagal dysfunction was seen in 51.4% of cases and 11.4% of controls (aOR: 10.1 [95% CI: 2.7 - 38.3], p = 0.001). This risk increased with the severity of HF-aOR: 11.8, [95% CI: 1.8 - 77.9], p = 0.01 for dyspnea stage III-IV, and aOR: 9.27, [95% CI: 1.3 - 65.3], p = 0.025) for HF with reduced Ejection fraction. This risk was not associated with the classic cardiovascular risk factors. Conclusion: Parasympathetic dysfunction as assessed with the Deep Breathing Test was seen in over half of the patients with HF and this was associated with the severity and type of HF.展开更多
The impaired autonomic nervous system(ANS) has a close relationship to morbidity and mortality for congestive heart failure(CHF). This study is aimed to investigate the possibility to characterize CHF by the pattern o...The impaired autonomic nervous system(ANS) has a close relationship to morbidity and mortality for congestive heart failure(CHF). This study is aimed to investigate the possibility to characterize CHF by the pattern of diurnal rhythm based on heart rate variability(HRV). Two datasets of CHF(n=44) were from Physio Net. And the datasets of the normal from THEW(n=189). Two 2 h episodes representing day and night in resting state were selected in each Holter record. Measures concerning time domain, AR model-based analysis, symbol dynamic analysis, and non-Gaussian indexes(λ) were calculated in each episode. The diurnal rhythm was represented by the ratio of an index in the day to that at night. Results demonstrated different patterns of diurnal rhythm among the normal, mild CHF(NYHAI-Ⅱ) and severe CHF(NYHA Ⅲ-Ⅳ),reflecting the changes in sympathetic and vagal interaction from reciprocal function to accentuated antagonism due to CHF. Furthermore, using RRIn,(LFnu)d/(LFnu)nand λd/λn,the sensitivity and specificity for discriminating the normal and CHF reached 95.45%and 95.24%;And for discriminating between mild CHF and severe CHF were 84.38%and 91.67%. Our proposed method is promising in assessing the ANS state and monitoring therapeutic effects for CHF patients.展开更多
目的探讨慢性心力衰竭(chronic heart failure,CHF)患者血清微小RNA-122(miR-122)和微小RNA-558(miR-558)水平表达与心功能及心率变异性的关系。方法收集2019年1月~2022年1月武汉市东西湖区人民医院收治的100例慢性心力衰竭患者作为研究...目的探讨慢性心力衰竭(chronic heart failure,CHF)患者血清微小RNA-122(miR-122)和微小RNA-558(miR-558)水平表达与心功能及心率变异性的关系。方法收集2019年1月~2022年1月武汉市东西湖区人民医院收治的100例慢性心力衰竭患者作为研究组,同期在该院进行体检的健康者100例作为对照组。采用实时荧光定量PCR法检测两组血清miR-122和miR-558表达水平;比较两组心率变异性指标及心功能指标;采用Pearson法分析慢性心力衰竭患者血清miR-122,miR-558表达水平与心率变异性指标、心功能指标的相关性;用Logistic回归分析影响慢性心力衰竭的危险因素。结果与对照组相比,慢性心力衰竭患者血清miR-122(0.86±0.19 vs 1.07±0.16)及心率变异性指标、左室射血分数(LVEF)均明显降低(t=3.844~15.448),miR-558(1.28±0.27 vs 1.02±0.12)表达水平及左室舒张末期容积指数(LVEDVI)、左室收缩末期容积指数(LVESVI)均明显升高(t=6.794~9.358),差异具有统计学意义(均P<0.05);不同心功能分级I,II级组患者血清miR-122(1.19±0.23,1.04±0.21)表达水平显著高于III,IV级组(0.68±0.16,0.53±0.15),miR-558(0.93±0.24,1.21±0.26)表达水平显著低于III,IV级组(1.42±0.27,1.64±0.29),差异具有统计学意义(qmiR-122=3.751~14.568,qmiR-558=3.929~11.194,均P<0.05)。慢性心力衰竭患者血清miR-122与心率变异性指标、LVEF均呈正相关性(r=0.337~0.573),与LVEDVI,LVESVI呈负相关性(r=-0.385,-0.323),血清miR-558与心率变异性指标、LVEF均呈负相关性(r=-0.646~-0.246),与LVEDVI,LVESVI呈正相关性(r=0.528,0.547);血清miR-122[OR(95%CI)=0.528(0.328~0.850)],miR-558[OR(95%CI)=2.845(1.364~5.933)]是慢性心力衰竭的影响因素(P<0.05)。结论慢性心力衰竭患者血清miR-122,miR-558表达水平与心功能、心率变异性密切相关,且血清miR-122和miR-558是慢性心力衰竭的影响因素。展开更多
文摘Objective A novel index based on fi-equency-domain analysis of heart rate variability （HRV） was tested on patients with reduced left ventricular systolic function. This index, namely VHFI, was defined as the very high frequency （VHF） component of the power spectrum normalized to represent its relative value in proportion to the total power minus the very low frequency component. Methods Patients （n = 130） were divided into a study group, consisting 66 patients with decreased left ventricular systolic function, and a control group, consisting 64 patients with normal heart structure and function and without severe coronary artery stenosis （〈 50%）. Results VHFI in the study group was significantly higher than that in the control group （19.17 ± 13.35 vs 11.37 ± 10.77, P 〈 0.001）. Cardiac events occurred in 18 patients during follow-up （33.34 i 3.26 months）. Defining the positive test as VHFI =15 and negative test as VHFI 〈15, achieved a sensitivity of 57.58% and a specificity of78.13% for predicting decreased left ventricular systolic function, and achieved a sensitivity of 66.67% and a specificity of 64.29% for predicting cardiac events. Univariate Cox regression analysis showed that positive VHFI test was an independent variable in predictive cardiac events. Conclusions The results suggest that VHFI is a useful tool for quick evaluation of left ventricular systolic function and prediction of prognosis
基金Project supported by the National Natural Science Foundation of China （Grant No.30540025）
文摘Assessing the dynamics of heart rate fluctuations can provide valuable information about heart status. In this study, regularity of heart rate variability （HRV） of heart failure patients and healthy persons using the concept of singular value decomposition entropy （SvdEn） is analyzed. SvdEn is calculated from the time series using normalized singular values. The advantage of this method is its simplicity and fast computation. It enables analysis of very short and non-stationary data sets. The results show that SvdEn of patients with congestive heart failure （CHF） shows a low value （SvdEn： 0.056±0.006, p 〈 0.01） which can be completely separated from healthy subjects. In addition, differences of SvdEn values between day and night are found for the healthy groups. SvdEn decreases with age. The lower the SvdEn values, the higher the risk of heart disease. Moreover, SvdEn is associated with the energy of heart rhythm. The results show that using SvdEn for discriminating HRV in different physiological states for clinical applications is feasible and simple.
文摘Aim: Congestive heart failure (CHF) is a severe cardiovascular disorder seen in the Emergency Department (ED). B-type Natriuretic Peptide (BNP) is usually ordered to evaluate the CHF severity. However, it is difficult to interpret serum BNP level when different clinical entities existed. The aim of this study is to illustrate the correlation between serum BNP level and relevant clinical variables and further determine the role of serum BNP in different CHF patients. Methods: Univariate comparisons between 26 clinical variables and serum BNP level were analyzed. In order to avoid confounding factors, potential independent clinical variables were analyzed together using multivariate regression. Results: 529 CHF patients were reviewed and divided into different groups by 26 clinical variables. Serum BNP levels were found statistically significant different by univariate compareson between groups divided by 8 clinical variables that included obesity, diastolic/systolic heart failure (HF), serum blood urea nitrogen (BUN) level, serum creatinine (Cr) level, serum sodium (Na) level, patients taking loop diuretics, history of cerebrovascular accident (CVA), and history of dementia. Among all 8 clinical variables, obesity, serum BUN, Cr level, and diastolic/systolic HF had weak-to-moderate correlation effects with serum BNP level by correlation coefficient analysis. However, only obesity and dia- stolic/systolic HF were two moderately stronger clini- cal variables that can affect the serum BNP levels by multivariate regression. Analyzing CHF patients separately by obesity and diastolic/systolic HF subsets showed longer hospitalization in diastolic HF patients with relatively higher serum Cr level. In addition, poor correlation was found between serum BNP level and length of hospitalization (LOH) as well. Conclusion: High variability of serum BNP levels exists in CHF patients with weak-to-moderate correlation effects particularly on obesity and diastolic/systolic HF.It is recommended that physicians should be cautious on interpreting BNP in different CHF populations.
文摘Nonlinear analysis of heart rate variability （HRV） has become important as heart behaves as a complex system. In this work, the approximate entropy （ApEn） has been used as a nonlinear measure. A new concept of estimating the ApEn in different segments of long length of the recorded data called modified multiple scale （segment） entropy （MMPE） is introduced. The idea of estimating the approximate entropy in different segments is useful to detect the nonlinear dynamics of the heart present in the entire length of data. The present work has been carried out for three cases namely the normal healthy heart （NHH） data, congestive heart failure （CHF） data and Atrial fibrillation （AF） data and the data are analyzed using MMPE techniques. It is observed that the mean value of ApEn for NHH data is much higher than the mean values for CHF data and AF data. The ApEn profiles of CHF, AF and NHH data for different segments obtained using MPE profiles measures the heart dynamism for the three different cases. Also the power spectral density is obtained using fast fourier transform （FFT） analysis and the ratio of LF/HF （low frequency/high frequency） power are computed on multiple scales/segments namely MPLH （multiple scale low frequency to high frequency） for the NHH data, CHF data and AF data and analyzed using MPLH techniques. The results are presented and discussed in the paper.
文摘Background Chronic heart failure(CHF)is the end-stage manifestation and main cause of death of cardiovascular system diseases.Ventricular arrhythmia is a common complication,which can increase myocardial oxygen consumption,aggravate the disease,and even cause sudden death due to malignant arrhythmia.As a quantitative method to evaluate cardiac autonomic nervous function,heart rate variability is non-invasive and reproducible,and can quantify the risk associated with various cardiac and non-cardiac diseases.The purpose of this study was to analyze the correlation between heart rate variability and the incidence of cardiovascular adverse events in patients with heart failure.Methods 80 patients with heart failure who were treated in our hospital from May 2020 to May 2022 were selected as the study objects.After 3 months of follow-up,patients were divided into occurrence group(n=44)and nonoccurrence group(n=36)according to the occurrence of adverse cardiovascular events(angina pectoris,myocardial infarction,arrhythmia).The index of heart rate variability and the indicators of cardiac function in patients with heart failure was analyzed by one-way analysis of variance(ANOVA).The Key indicators of heart rate variability include standard deviation of normal RR interval(SDNN),mean standard deviation of consecutive 5-minute heartbeat interval(SDANN),square root of mean square of difference between adjacent heartbeat intervals(RMSSD),and percentage of RR intervals differing more than 50 ms from the preceding one(PNN50).The indicators of cardiac function include the New York Heart Association(NYHA)functional classification,left ventricular ejection fraction(LVEF),brain natriuretic peptide(BNP)and cardiac troponin I(c Tn I).Multivariate logistic regression was used to analyze the incidence of cardiovascular adverse events in patients with heart failure.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of heart rate variability in patient outcomes.The correlation between heart rate variability and the incidence of cardiovascular adverse events was analyzed by Kendall's tau-b analysis.Results There were significant differences in SDNN,SDANN,RMSSD,PNN50,cardiac function grade,LVEF and BNP level between the two groups(P<0.05).Through logistic regression analysis,SDNN,SDANN,RMSSD and PNN50 were independent predictors for the incidence of cardiovascular adverse events(P<0.05).The areas under curve for SDNN,SDANN,RMSSD,and PNN50 predicting of the incidence of cardiovascular adverse events were 0.732,0.732,0.758,and 0.819 respectively,and the sensitivity was 77.27%,81.81%,75.00%and 65.91%,respectively.The specificity was 61.11%,61.11%,80.56%,83.33%(P<0.05),respectively.Through Kendall's tau-b analysis,the index of heart rate variability was negatively correlated with the incidence of adverse cardiovascular events in patients with prognosis(P<0.05).Conclusions Heart rate variability has predictive value for the incidence of adverse cardiovascular events in patients with heart failure.The lower the heart rate variability,the higher incidence of cardiovascular adverse events.[S Chin J Cardiol 2024;25(3):135-141]
文摘Background: Heart Failure (HF) is a major public health problem worldwide. Neurohormonal changes associated with HF are current therapeutic targets. The parasympathetic system in HF has not been well studied especially in black Africans. Aim: This study aimed to report on the prevalence and determinants of parasympathetic dysfunction in patients with heart failure in sub-Saharan Africa. Methods: We conducted a cross-sectional study between December 2017 and April 2018 in the outpatient and inpatient departments in two teaching hospitals in Yaounde-Cameroon. Cases were patients with HF matched with controls without HF according to age, sex, and risk factors (hypertension, diabetes, and obesity). We assessed the parasympathetic function via the Deep Breathing Test using an electrocardiograph. Results: We recruited 35 patients in each group. The mean age was 57 ± 11.68 years. Vagal dysfunction was seen in 51.4% of cases and 11.4% of controls (aOR: 10.1 [95% CI: 2.7 - 38.3], p = 0.001). This risk increased with the severity of HF-aOR: 11.8, [95% CI: 1.8 - 77.9], p = 0.01 for dyspnea stage III-IV, and aOR: 9.27, [95% CI: 1.3 - 65.3], p = 0.025) for HF with reduced Ejection fraction. This risk was not associated with the classic cardiovascular risk factors. Conclusion: Parasympathetic dysfunction as assessed with the Deep Breathing Test was seen in over half of the patients with HF and this was associated with the severity and type of HF.
基金National Natural Science Foundation of Chinagrant number:81471746,81071225+1 种基金Innovation Project of Medicine and Health Science and Technology of Chinese Academy of Medical Sciencesgrant number:2016-12M-3-08。
文摘The impaired autonomic nervous system(ANS) has a close relationship to morbidity and mortality for congestive heart failure(CHF). This study is aimed to investigate the possibility to characterize CHF by the pattern of diurnal rhythm based on heart rate variability(HRV). Two datasets of CHF(n=44) were from Physio Net. And the datasets of the normal from THEW(n=189). Two 2 h episodes representing day and night in resting state were selected in each Holter record. Measures concerning time domain, AR model-based analysis, symbol dynamic analysis, and non-Gaussian indexes(λ) were calculated in each episode. The diurnal rhythm was represented by the ratio of an index in the day to that at night. Results demonstrated different patterns of diurnal rhythm among the normal, mild CHF(NYHAI-Ⅱ) and severe CHF(NYHA Ⅲ-Ⅳ),reflecting the changes in sympathetic and vagal interaction from reciprocal function to accentuated antagonism due to CHF. Furthermore, using RRIn,(LFnu)d/(LFnu)nand λd/λn,the sensitivity and specificity for discriminating the normal and CHF reached 95.45%and 95.24%;And for discriminating between mild CHF and severe CHF were 84.38%and 91.67%. Our proposed method is promising in assessing the ANS state and monitoring therapeutic effects for CHF patients.
文摘目的探讨慢性心力衰竭(chronic heart failure,CHF)患者血清微小RNA-122(miR-122)和微小RNA-558(miR-558)水平表达与心功能及心率变异性的关系。方法收集2019年1月~2022年1月武汉市东西湖区人民医院收治的100例慢性心力衰竭患者作为研究组,同期在该院进行体检的健康者100例作为对照组。采用实时荧光定量PCR法检测两组血清miR-122和miR-558表达水平;比较两组心率变异性指标及心功能指标;采用Pearson法分析慢性心力衰竭患者血清miR-122,miR-558表达水平与心率变异性指标、心功能指标的相关性;用Logistic回归分析影响慢性心力衰竭的危险因素。结果与对照组相比,慢性心力衰竭患者血清miR-122(0.86±0.19 vs 1.07±0.16)及心率变异性指标、左室射血分数(LVEF)均明显降低(t=3.844~15.448),miR-558(1.28±0.27 vs 1.02±0.12)表达水平及左室舒张末期容积指数(LVEDVI)、左室收缩末期容积指数(LVESVI)均明显升高(t=6.794~9.358),差异具有统计学意义(均P<0.05);不同心功能分级I,II级组患者血清miR-122(1.19±0.23,1.04±0.21)表达水平显著高于III,IV级组(0.68±0.16,0.53±0.15),miR-558(0.93±0.24,1.21±0.26)表达水平显著低于III,IV级组(1.42±0.27,1.64±0.29),差异具有统计学意义(qmiR-122=3.751~14.568,qmiR-558=3.929~11.194,均P<0.05)。慢性心力衰竭患者血清miR-122与心率变异性指标、LVEF均呈正相关性(r=0.337~0.573),与LVEDVI,LVESVI呈负相关性(r=-0.385,-0.323),血清miR-558与心率变异性指标、LVEF均呈负相关性(r=-0.646~-0.246),与LVEDVI,LVESVI呈正相关性(r=0.528,0.547);血清miR-122[OR(95%CI)=0.528(0.328~0.850)],miR-558[OR(95%CI)=2.845(1.364~5.933)]是慢性心力衰竭的影响因素(P<0.05)。结论慢性心力衰竭患者血清miR-122,miR-558表达水平与心功能、心率变异性密切相关,且血清miR-122和miR-558是慢性心力衰竭的影响因素。
文摘目的研究养心健脾汤对心力衰竭(heart failure,HF)患者的疗效及心率变异性、血清因子的影响。方法选取2022年1月至2023年10月我院收治的100例HF患者为研究对象,根据治疗方案分为对照组和研究组,各50例。对照组采用曲美他嗪治疗,研究组在对照组基础上加用养心健脾汤治疗。比较两组临床疗效、治疗前后中医证候积分、心率变异性指标[正常窦性心搏间期标准差(SDNN)、正常相邻窦性心搏间期差值的均方根(RMSSD)、全程每5 min NN节段的窦性RR间期标准差(SDANN)、相邻窦性心搏间期差值>50 ms心搏数百分比(PNN50)]、血清细胞因子[超敏C反应蛋白(hs-CRP)、B型脑利钠肽(BNP)、组蛋白脱乙酰酶2(HDAC2)、分泌型卷曲相关蛋白2(SFRP2)]水平、不良反应发生率。结果研究组临床总有效率(96.00%)高于对照组(82.00%)(P<0.05);治疗1个月后,研究组水肿、气喘、心悸、畏寒肢冷评分低于对照组(P<0.05);治疗1个月后,研究组SDNN、RMSSD、SDANN、PNN50高于对照组(P<0.05);治疗1个月后,研究组血清hs-CRP、BNP、HDAC2水平低于对照组,SFRP2水平高于对照组(P<0.05);研究组不良反应总发生率(12.00%)与对照组(8.00%)相比,差异无统计学意义(P>0.05)。结论采用养心健脾汤与曲美他嗪联合治疗可有效促进HF患者心率变异性改善,缓解炎症状态及临床症状,增强疗效,安全性良好。
